Patients after a severe course of COVID-19 may become respiratory disabled. In some people, we are dealing with irreversible changes in the lungs, which cause a permanent limitation of respiratory reserves and respiratory failure of the patient – noted pulmonologist Dr. hab. Robert Kieszko, MD, PhD.
Deputy head of the Department of Pneumology, Oncology and Allergology, SPSK4 in Lublin, dr hab. Robert Kieszko, MD, emphasized that the most common symptoms in the severe course of COVID-19 are pneumonia and pulmonary embolism. «This pneumonia is interstitial in nature, during which inflammatory cell infiltrates form in the alveoli. There is one more problem on top of this, because vascular endothelial inflammation, intravascular coagulation and thrombus formation often occur, and as a consequence pulmonary embolism »- explained the pulmonologist.
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As he emphasized, some patients experience the so-called cytokine storm, i.e. excessive cytokine release by the immune system, which destroys the lung parenchyma and leads to pulmonary fibrosis. “If connective tissue overgrows in the lung parenchyma, we are dealing with irreversible fibrosis, which permanently reduces the patient’s respiratory reserves. The consequence of lung damage is respiratory failure, i.e. reduced partial pressure of oxygen in the blood and limited ability to exercise. In other words, the patient often becomes a respiratory disability »- noted dr hab. n. med. Kieszko.
Among other postovid complications in the respiratory system, he mentioned i.a. bronchial hyperreactivity, troublesome and tiring cough.
During the interview with PAP, he pointed out that, apart from infectious diseases wards, patients with COVID-19 are most often treated in pulmonary wards, which have been transformed into covid wards. “This is due to the fact that the pulmonary wards are a legacy of phtysiatry wards, i.e. tuberculosis wards, which for epidemic reasons were usually located in separate buildings, so now it is easiest to annex such an infectious ward” – said the deputy head of the Department of Pneumology, Oncology and Allergology SPSK4 in Lublin.
He emphasized that due to the COVID-19 pandemic, most of the pulmonology units in the region are not fully operational due to the transformation of entire units or parts of them into units dealing with the treatment of COVID-19 infections.
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“Therefore, there are no places for elective pulmonary patients in the diagnosis and treatment of respiratory diseases. This includes, for example, the diagnosis of lung cancer, the treatment of the exacerbation of chronic obstructive pulmonary disease, bronchial asthma or idiopathic pulmonary fibrosis »the doctor calculated.
When asked about the consequences of this lack of access to treatment for patients with other lung diseases, he replied that “it will limit the possibility of proper treatment of chronic respiratory diseases”. «The long-term consequences of this failure of the health care system will be a deterioration in the quality and life expectancy of patients. I think we will observe it in the coming years, but we already have an excess of deaths, not only from epidemics »- explained Dr. n. med. Kieszko.
As he noted, despite the epidemic, hospitals try to provide diagnostics to patients with respiratory diseases. The Lublin clinic still has a bronchoscopy laboratory, where up to six bronchoscopic examinations are performed daily with pinch and needle aspiration biopsy procedures under the control of endobronchial ultrasound, allowing for the diagnosis of lung cancer and other respiratory diseases.
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«In our hospital, two floors – 28 beds – pulmonology clinics are currently intended for those infected with COVID-19, and one floor, ie 16 beds, for the treatment of lung cancer patients. We cannot postpone such treatment. We also have a one-day lung cancer treatment unit, which serves a dozen or so patients every day »- emphasized the pulmonologist.
Author: Gabriela Bogaczyk
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